Published online before print November 14, 2005, doi: 10.1161/01.HYP.0000188904.47575.7e
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(Hypertension. 2005;46:1252.)
© 2005 American Heart Association, Inc.
Editorial Commentaries |
Thrombophilia and Severe Preeclampsia
Time to Screen and Treat in Future Pregnancies?
From the Department of Obstetrics and Gynecology, University of Cincinnati, Ohio.
Correspondence to Baha M. Sibai, University of Cincinnati, 231 Albert Sabin Way, Cincinnati, OH 45267. E-mail baha.sibai@uc.edu
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
The term thrombophilia is used to describe a heterogenous group of coagulation abnormalities (acquired or inherited) that are generally associated with increased risk of arterial and venous thrombosis.1 Antiphospholipid antibodies (APA) is the most frequent acquired thrombophilic disorder during pregnancy. It is generally diagnosed in the presence of elevated levels of IgG and IgM (GpL or MpL values 
20) or the presence of lupus auticoagulant.2 The most common inherited thrombophilic disorders during pregnancy are mutations in factor V Leiden (FVL), prothrombin gene, and tetrahydrofolate reductase. During the past 2 decades, epidemiologic and case-control studies have evaluated the association between thrombophilias and adverse pregnancy outcome (APO), specifically, preeclampsia and intrauterine fetal growth restriction (IUGR).1–5
An association between severe preeclampsia at <34 weeks and APA was first reported by Branch et al in 1989.2 Based on this report, recommendations were made that women with severe preeclampsia at <34 weeks be screened for the presence of APA and be treated if positive in subsequent pregnancies. Since that publication, several studies were published supporting or refuting an association between these antibodies and preeclampsia.6,7 Indeed, a recent report concluded that data do not support routine testing for APA in women with early-onset preeclampsia.6
An association between preeclampsia and inherited thrombophilias was first reported by Dekker et al in 1995.8 Since then, a large number of retrospective and case-controlled studies have examined the association between carriage of thrombophilic mutations and preeclampsia. These studies were the subject of several reviews.1,3,4 Overall, the results of published reports have
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